What Is Non-Ulcer Dyspepsia?

Non-ulcerative dyspepsia (NUD), also known as functional dyspepsia, is a common disease, the exact etiology and pathogenesis of which is not yet clear. The cause may involve multiple factors, including chronic inflammation of the stomach, duodenal mucosa, upper gastrointestinal dysfunction, and neuropsychological factors. Many other diseases of the digestive system and some organic diseases of the digestive tract can even appear in the early stage of malignant tumors. Therefore, a cautious attitude should be taken in the diagnosis of non-ulcerative dyspepsia. After a comprehensive examination of the patient, no other abnormalities are found, and diabetes and hypothyroidism must be excluded before the diagnosis can be made. Patients with ulcerative dyspepsia should also follow up.

Basic Information

nickname: Functional dyspepsia
English name: nonulcer dyspepsia
Visiting department: Internal medicine

Common locations: Digestive system
Common causes: Gastric motor dysfunction, mild gastroduodenal inflammation, Helicobacter pylori (Hp) infection, anxiety, depression, restlessness, etc.
Common symptoms: Bloating, early satiety, belching, etc.

Causes of non-ulcerative dyspepsia

Gastric motor dysfunction

If gastric motor dysfunction occurs and food stays in the stomach, it cannot be discharged into the duodenum in time, which will inevitably lead to indigestion.

2. Mild gastroduodenal inflammation

According to a census, in patients with non-ulcerative dyspepsia, 1/3 to 1/2 of the patients have confirmed chronic superficial inflammation of the stomach, and about 1/5 of them have duodenitis.

3. Helicobacter pylori (Hp) infection

Hp can be detected in the gastric mucosa of more than half of patients with non-ulcerative dyspepsia.

4. Mental factors

Most patients with non-ulcerative dyspepsia have anxiety, depression, restlessness, and suspected conditions (especially cancer); a few have neurological symptoms such as insomnia, nervousness, and exaggerated speech. Patients often describe their illness as very serious, it seems The consequences are disastrous and cause worry all day. Psychological factors can affect the movement, secretion, and blood supply of the gastrointestinal tract through the autonomic nervous system, and eventually lead to the occurrence of non-ulcerative dyspepsia.

Clinical manifestations of non-ulcerative dyspepsia

Bloating, early satiety, and belching are the most common symptoms of functional dyspepsia. Patients with functional dyspepsia sometimes have severe symptoms such as abdominal distension, early satiety, and belching, or have recurrent attacks, but generally do not experience symptoms such as weight loss and anemia. Clinical classification can be divided into reflux-like, dyskinesia-like, ulcer-like, idiopathic dyspepsia, and emphysema.

Non-ulcerative dyspepsia test

1. Blood routine, urine routine, and fecal routine examination.

2. Liver function and kidney function.

3. Viral hepatitis immunological examination.

4. X-ray examination, B-mode ultrasound examination.

5. Detection of electrolytes and some trace elements.

6. Cardiovascular examination.

7. Endoscopy Endoscopy can find organic lesions such as ulcers, erosions, and tumors.

8. Radionuclides (isotopes) are used to assess gastric emptying.

Non-ulcerative dyspepsia diagnosis

Non-ulcerative dyspepsia can be considered if:

1. Have the above symptoms of functional dyspepsia.

2. Endoscopy is normal or excludes active periods of chronic gastritis (such as bleeding, erosion) and organic lesions such as ulcers and tumors.

3. Laboratory examination, B-ultrasound or X-ray examination exclude organic lesions of liver, gallbladder, pancreas and other organs.

Differential diagnosis of non-ulcerative dyspepsia

Should be distinguished from some organic diseases, such as gastric ulcers, duodenal ulcers, gallbladder and pancreatic diseases, and even dyspepsia caused by tumors.

Non-ulcerative dyspepsia complications

Can be combined with the symptoms of irritable bowel syndrome.

Non-ulcerative dyspepsia treatment

1. Psychological and mental therapy

When the patient learns that he has non-ulcerative dyspepsia, he should relax his heart and chest, avoid panic and nervousness, and actively cooperate with doctors to insist on regular treatment. Although non-ulcerative dyspepsia is difficult to completely cure in a short period of time, it will not have serious adverse consequences, let alone develop into gastric cancer. Patients with severe conditions can also choose psychotropic drugs under the guidance of a doctor, such as amitriptyline, doxepin, maprotiline (ludimet), fluoxetine, clomipramine, and flupentazol Melitrazine (Delixin), Oryzanol, Fenalu and Baizi Yangxin Pills.

2. Gastrointestinal prokinetic drugs mainly include

Modin (also known as domperidone): This medicine can enhance the peristalsis of the gastrointestinal tract and promote gastric emptying, so as to regulate or restore the normal activities of the patient's gastrointestinal tract and allow food to enter the twelve fingers Intestine, which has some effect in eliminating symptoms caused by non-ulcerative dyspepsia. Etopril: This medicine has the dual effects of dopamine D2 receptor block and acetylcholinesterase inhibition. It stimulates gastric and duodenal movement and stimulates gastric emptying by stimulating the release of endogenous acetylcholine and inhibiting its hydrolysis. And has a moderate antiemetic effect. Metoclopramide (also known as metolin): This medicine is an old gastrointestinal booster. Patients with non-ulcerative dyspepsia can also use this medicine when they do not have morpholine and itopride.

3. Symptomatic treatment

For patients with non-ulcerative dyspepsia, belladonna tablets, atropine, or 654-2 can be used for treatment of upper abdominal pain; Dimethicone or antibulk tablets can be used for treatment of abdominal distension and belching; If you have nausea and vomiting, you can use vitamin B6; If you have heartburn and acid reflux, you can use antacids, such as compound aluminum hydroxide (weishuping); rate of magnesium carbonate (daxi), etc .; Ranitidine, famotidine; proton pump inhibitors, such as omeprazole, lansoprazole, pantoprazole, esomeprazole and other drugs for treatment.

Non-ulcerative dyspepsia prevention

The prognosis of this disease is good. Patients with functional dyspepsia should avoid greasy and irritating foods in their diet, quit smoking and alcohol, develop good living habits, avoid overeating and overeating before going to bed; take less and more food; strengthen physical exercise; Pay special attention to maintaining a happy mood and a good mood.